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A patient who underwent a percutaneous, transluminal coronary angioplasty four weeks ago has a subsequent ejection fraction of 30%. The patient returns for a follow-up visit. Examination reveals lungs that are clear on auscultation and slight pedal edema. The patient's medications are digoxin (Lanoxin), furosemide (Lasix), enalapril maleate (Vasotec), and aspirin. The patient reports a 5 lb (2.27 kg) weight gain over the past two days. The cardiac-vascular nurse's initial action is to:
- A. document the weight and reassess the patient at the next session.
- B. inquire about the patient's medication compliance.
- C. notify the patient's physician.
- D. review the patient's most recent nuclear scan.
Correct Answer: B
Rationale: Weight gain and pedal edema suggest fluid retention, so assessing medication compliance is essential.
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If Mrs. Jones has a temporary pacemaker and the pacemaker intermittently fails to capture or sense, increasing the output temporarily restores function. Failure to capture or sense appropriately is most often due to
- A. Prior emergency defibrillation for ventricular failure
- B. Dislodgment of pacing electrode from right ventricle
- C. Occurrence of frequent ectopic beats from right ventricle
- D. Perforation to the right ventricle by pacing electrode
Correct Answer: B
Rationale: Dislodgment affects proper pacemaker function.
Which chronic condition is characterized by abnormally thickened heart muscle, making it harder for the heart to pump blood efficiently?
- A. Hypertrophic cardiomyopathy
- B. Dilated cardiomyopathy
- C. Restrictive cardiomyopathy
- D. Ventricular hypertrophy
Correct Answer: A
Rationale: Rationale:
1. Hypertrophic cardiomyopathy (HCM) is characterized by thickening of the heart muscle.
2. The thickening reduces the heart's ability to pump blood efficiently.
3. This leads to symptoms like shortness of breath, chest pain, and fatigue.
4. HCM is a genetic condition that affects the heart's structure.
5. Dilated cardiomyopathy involves the heart becoming enlarged, not thickened.
6. Restrictive cardiomyopathy refers to stiffening of the heart muscle.
7. Ventricular hypertrophy is a general term for thickening of the heart's chambers, not the muscle itself.
Summary:
A is correct as HCM matches the description provided. B, C, and D do not align with the specific characteristics of abnormally thickened heart muscle seen in HCM.
Which condition is characterized by the narrowing or blockage of arteries that supply blood to the heart by plaque?
- A. Coronary artery disease (CAD)
- B. Atherosclerosis
- C. Peripheral artery disease
- D. Congestive heart failure
Correct Answer: A
Rationale: The correct answer is A: Coronary artery disease (CAD). CAD is characterized by the narrowing or blockage of arteries supplying blood to the heart by plaque buildup. Plaque consists of cholesterol, fat, calcium, and other substances that can restrict blood flow to the heart, leading to various heart-related issues. Atherosclerosis (B) is the process of plaque buildup in arteries but is not specific to the heart. Peripheral artery disease (C) involves plaque buildup in arteries outside the heart. Congestive heart failure (D) is a condition where the heart cannot pump blood effectively, not directly related to plaque buildup in coronary arteries.
If Mr. Smith is admitted with pericarditis with effusion and shows dyspnea, tachycardia, distended neck veins, and arterial hypotension, your evaluation of the situation would be that
- A. These are signs of cardiac tamponade
- B. These signs are to be expected
- C. He needs to be placed flat in bed to relieve the problem
- D. He has overexerted himself and needs to rest
Correct Answer: A
Rationale: Cardiac tamponade compromises cardiac function.
A patient recently had a cardiac catheterization via right-radial approach and now has a compression device in place. The patient reports numbness and pain in the right hand. The cardiac-vascular nurse notes a diminished pulse, with a cool and cyanotic hand. The nurse:
- A. calls the physician.
- B. performs an Allen test.
- C. reduces the pressure on the puncture site.
- D. uses the Doppler ultrasound to assess for pulse signals.
Correct Answer: C
Rationale: Reducing pressure on the puncture site is necessary to restore blood flow to the hand.